A nursing student is preparing to give a medication that has a boxed warning. The student asks the nurse what this means. What will the nurse explain about boxed warnings?

Choice A Reason:

Bronchoconstriction is the narrowing of the airways in the lungs due to the tightening of surrounding smooth muscle. This response is typically associated with conditions like asthma and is not a common reaction to acute stress. During stress, the sympathetic nervous system actually causes bronchodilation to increase airflow and oxygen delivery to the muscles.

Choice B Reason:

This is the correct answer. Increased glucose production is a typical response to acute stress. The body releases stress hormones like adrenaline and cortisol, which stimulate the liver to produce more glucose. This process, known as glycogenolysis, ensures that the body has enough energy to handle the stressor. This response is part of the “fight-or-flight” mechanism, preparing the body for immediate physical activity.

Choice C Reason:

Decreased cortisol release is not expected during acute stress. In fact, cortisol levels typically increase as part of the body’s stress response. Cortisol helps to mobilize energy stores, suppress inflammation, and support cardiovascular function. Therefore, this choice is incorrect.

Choice D Reason:

Bradycardia, or a slower than normal heart rate, is not a typical response to acute stress. Instead, the sympathetic nervous system increases heart rate (tachycardia) to ensure that more blood is pumped to vital organs and muscles. This helps the body to respond more effectively to the stressor.

Choice A Reason:

Norepinephrine is a key neurotransmitter released by the sympathetic nervous system during the “fight-or-flight” response. It plays a crucial role in preparing the body to respond to stress by increasing heart rate, blood pressure, and blood flow to muscles, as well as dilating the airways. These physiological changes are essential for coping with acute stress.

Choice B Reason:

Cortisol is a hormone released by the adrenal glands in response to stress, but it is primarily associated with the hypothalamic-pituitary-adrenal (HPA) axis rather than the sympathetic nervous system. While cortisol contributes to the body’s overall stress response by increasing blood sugar levels and suppressing the immune system, it is not the primary mediator of the acute “fight-or-flight” response.

Choice C Reason:

ACTH (adrenocorticotropic hormone) is a hormone produced by the pituitary gland that stimulates the adrenal glands to release cortisol. It is part of the HPA axis and plays a role in the body’s long-term stress response, but it is not directly involved in the immediate activation of the sympathetic nervous system.

Choice D Reason:

Glucagon is a hormone produced by the pancreas that raises blood glucose levels by promoting the breakdown of glycogen to glucose in the liver. While it can be involved in the body’s response to stress by ensuring an adequate supply of glucose, it is not a primary mediator of the acute stress response mediated by the sympathetic nervous system.